Epidemiology and Health

Volume 20 (1); June 1998

Original Articles

The Association of Hyperinsulinemia with Other Cardiovascular Risk Factors.: Kang Sook Lee, Bok Rye Song; Korean J Epidemiol. 1998;20(1):167-177.

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Abstract PDF: Abstract
BACKGROUND
Hypertension, obesity, non-insulin dependent diabetes(NIDDM), and dyslipidemia are common metaolic disorders that afflict the majority of the elderly who live in Westernized societies. To explore whether the hyperinsulinemia associated with other cardiovascular risk factors in Asian populations such as Koreans.
METHODS
In this cross-sectional study we evaluated the association of hyperinsulinemia with hypertension, obesity, diabetes and hyperlipidemia. Subjects were 600 men and 396 women at least 20 years old who visited the prevention center at St. Mary's Hospital in Seoul, between March and August 1997 for a multiphasic health examination.
RESULTS
In hyperinsulinemia group( >90 percentile of fasting blood insulin 10.01uU/ml in men and 8.54 uU/mlin women), body mass index(BMI), fasting blood sugar, and triglyceride and systolic or diastolic blood pressure were significantly higher than normal insulin goup in both of men and women. The major contributable risk factor to blood insulin concentration was BMI(14% in men, 13% in women). In person with the highest tertile of insulin concentration compared with those in the lowest tertile, age adjusted odds ratio of hypertension, obesity, and hypertriglyceride were 2.22(95% Confidence Interval: 1.38-3.63), 6.96(4.31-11.51), and 4.05(1.88-9.75) in men, and 2.05(95% CI: 1.10-3.86), 4.34(2.39-8.16) and 6.84(1.18-129.40) in women. Age adjusted odds ratio for clusterin of cardiovascular risk factors in the higest tertile of insulin compared with those in lower insulin than that level were 8.74(2.82-29.27) in men and 4.91(1.19-21.79) in women.
CONCLUSION
The hyperinsulinemia was associated with hypertension, obesity, NIDDM and hypertriglyceridemia. Further prospective studies are required to investigate the effects of intervetion to improve insulin sensitivity such as calorie restriction and exercise.; Summary

A Case-Control Study on dietary Factors of Colorectal Adenomatous Polyps by Sites.: Mi Kyung Kim, Won Chul Lee, Kyu Yong Choi, Su Kil Kim, Se Young Lee, Yang Cha Lee-Kim, Kwang Ho Meng; Korean J Epidemiol. 1998;20(1):154-166.

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Colorectal adenomas are benign neoplasm in the large bowel that are thought to be precursors lesion to colorectal cancer. So, studying adenomatous polyps instead of cancer might allow one to measure the diet of relatively asymptomatic subjects closer to the time of the initial neoplastic process. Some dietary factor, or set of factors, apparently plays an impotant role in the etiology of colorectal adenomatous polyps. The difference of the possible association of colorectal adenomatous polyps with dietary risk factors by anatomic subsite and gender was investigated in this case-control study. Between July 1994 and April 1998, 314 cases of patients with pathologically confirmed incident colorectal adenomatous polyps and 88 control subjects were collected from Our Lady of Mercy Hospital, The Catholic University. After colonoscopy, infor-mation on exposure was obtained by the interviewers. Also, subjects were interviewed using the semiquantitative food frequency questionnaire, and average daily nutrient intakes were calculated. Site- and gender-specific odds ratio relative to the lowest tertile of intake for each nutrient were determined using unconditional logistic regression after adjusting for a number of potential confounders. In females, significant odds ratio were found for b-carotene(0.31, 95% CI, 0.10~0.95), vitamin C(0.11, 95% CI, 0.02~0.61), vitamin-E(0.11, 95% CI, 0.02~0.78) in right colon but only the odds ratio of vitamin E(0.17, 95% CI, 0.03~0.90) was statistically significant in left colon. Among food groups, the odds ratio of green yellow vegetables was significant(OR=0.21, 95% CI, 0.05~0.96) in right colon. In males, almost all the above dietary factors were statistically not significant. In males, cigarette smoking appears to be a signigicant risk factor(OR=8.86, 95% CI, 1.10~71.5) in left colon, it was statistically not signigicant(OR=1.63, 95% CI, 0.42~4.76) in the right colon. Findings fron this study show that many associations of the nutrients with colorectal adenomatous polyps risk are different by anatomic subsite and gender and support the hypothesis that high intake of antioxidant vitamins and green yellow vagetables decreases the risk of polyps.; Summary

Epidemiologic Characteristics of the Pneumoconiosis Patients in Manufacturing Industries.: Won Chul Lee, Hyeon Woo Yim, Kyung Jae Lee, Se Yong Lee, Kwang Ho Meng, Young Gyu Phee, Hyun Wook Kim, Jung Wan Koo, Young Lim, Im Goung Yun; Korean J Epidemiol. 1998;20(1):141-153.

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Pneumoconiosis was the first reported occupational disease in Korea and was the most common one until 1990. In the past, most pneumoconiosis patients were found among underground workers in various mines. Recently this occupational disease has increasingly affected workers in manufacturing industries such as ship building, briquette, glass, foundry industries, and so on. In order to investigate the scale of pneumoconiosis in manufacturing industries, we evaluated the detailed medical examination records and insurance deliberation data from 1989 until 1994. Information about work history, medical history, and exposure dust type were collected for each member of the study population. All chest X-rays were interpreted and classified using the International Labor Organization(ILO) scale by three radiologist who have had extensive experience evaluation pneumoconiosis. For the calculation of the incidence rate of manufacturing pneumoconiosis, we analyzed the Specific Health Examination data and estimated the population at risk as a denominator of the incidence rate. We divided manufacturing industry into 9 subclasses by industrial classification and estimated the incidence rate of pneumoconiosis per 100,000 workers at risk respectively. The results were as follows, 1. 485 workers were newly diagnosed with pneumoconiosis during 6 years from 1989 to 1994. 482 workers had radiographs consistent with simple pneumoconiosis and three with progressive massive fibrosis. Among those with radiographs consistent with simple pneumoconiosis, 395 workers(81.4%) had category 1 profusion, 76 workers(15.7%) had category 2 profusion and 11 workers(2.3%) had category 3 profusion. 2. Almost all of them were male(97.9%) and their average age was 48.3 uears. Manufacturing pneumoconiosis patients were more common in their forties and fifties. 3. The average duration of dust exposure required for the occurrence of pneumoconiosis was 13.5 years. In the case of metal products manufacturing which is mostly related to welding, the average duration of dust exposure was 12.0 years. It was slightly shorter than other manufacturing industries. The average duration of dust exposure required for the occurrence of pneumoconiosis seemed to be shorter in welding operators, even though the welders lung has a weak tissue reaction and the condition is reversible. 4. According to the Industrial classification, 299 cases(61.6%) were found in workers of non-metal mineral products manufacturing, and 56 cases(11.5%) in basic metals industry. 5. The average annual incidence rate of pneumoconiosis in manufacturing industries from 1990 to 1994 was 56.6 per 100,000 workers at risk. On sub-classification, the average annual incidence rate of pneumoconiosis in non-metal mineral products manufacturing industry was the highest among them, showing 479 per 100,000 workers at risk. 6. Radiologic prevalence rate of tuberculosis in these cases was 6.6%. 7. X-ray category profusion in newly diagnosed manufacturing pneumoconiosis varied according to sub-classification. The proportion of category 1 profusion in metal products manufacturing is higher than that in non-metal mineral products manufacturing. 8. The type pattern of small round opacities varied according to sub-classification in manufacturing industry. In non-metal mineral products manufacturing, the small round opacity were observed 25.9% cases with p type, 72.1% with q type and 2.0% with r type respectively. But in metal products manufacturing, the small round opacity were observed 51.4% cases with p type and 48.6% with q type respectively. The cause might be that the exposed dust is different according to job. 9. The type pattern of small round opacities varied according to dust type. Metal dusts showed similar radiologic shape to the coal dusts, but welding fume showed more frequent p type(60.3%) and less frequent q type(377%). rock dust showed less frequent p types(18.3%) and more frequent q types(75.3%). Since the incidence rate of non-metal manufacturing workers showed higher rate than other manufacturing industry, Preventive measures and health care education should be carefully carried out in these workers.; Summary

A Survey on Physical Activities of Middle-aged Women Workers.: Moon Hee Jung; Korean J Epidemiol. 1998;20(1):126-140.

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This study was conducted to look into physical activities of middle-aged women workers and various factors related to them. Two sample groups of women workers were selected in a ceramic factory located in the suburbs of Mokpo city in Chonnam Provincd: the middle-aged group(73 women workers aged between 45-49) and the compared group(60 women workers aged between 35-39). Data were colledted curing the period of July 1-20, 1996. 1. The average score of job-related physical activities were 3.09 and 3.39 in the middle-aged group and the compared group respectively. However, when it comes to leisure-time physical activities, the two groups revealed little difference, scoring 1.50 on average. These facts show us that middle-aged women workers have little concern with their leisure-time physical activities because they perceive their job activities as heavy. 2. As for the middle-aged group, the most influential variables on job-related physical activities were 'speed of eating', 'body figure' and 'blood sugar level'. Only these three variables could account for 22.2% of job-related activities of middle-aged women workers. These results imply that the faster they eat, the closer their body figure is to fatness type, and the higher their blood sugar level is, the heavier they perceive their job activities. 3. 'Body figure' was the most influential variable on Percent Ideal Body Weight(PIBW) in both the groups. It could explain 29.2% and 14.1% of PIBW in the middle-aged group and the compared group respectively. It means that the closer their body figure is to fatness type, the higher their PIBW gets. 4. As for 'body figure', 35.61% of the middle-aged group revealed fatness type. None the less, most of the middle-aged respondents perceived their 'body figure' as normal. According to the above results, I'd like to propose the followings: 1) It is necessary to provide middle-aged women workers with group health education of 'body figure'. 2) It is desirable to give workers various incentives for the active participation in walking campaign before and after work. 3) Indoor exercises such as rope-skipping and stepping in work sites as a recommendable as leisure-time physical activities.; Summary

Nationwide Telephone Survey on Leisure Time Physical Activity among Koreans.: Sung Hee Lee, Tae Woo Yoo, Joung Soon Kim; Korean J Epidemiol. 1998;20(1):113-125.

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Epidemiologic research has demonstrated that varying grade of physical activity has protective effects on several chronic diseases, including coronary heart disease, hypertension, diabetes mellitus, osteporosis, anxiety and depression. Despite the importance of physical activity as an health promotion factor, there have been only a few research data available in Korea. This telephone interview survey on randomly sampled 1,060 adultsaged 15-69 years was carried out to find out the prevalence of self-reported leisure-time physical activity among Korean adults in terms of health promotion practice. The nationwide telephone interview survey was conducted from April through May 1997. Multistage stratified random sampling method was used for sample selection, the respondent was randomly selected from an entire group of adults who lived at the residence connected with the telephone number. A total of 1,060 adults were interviewed and the interviewees' leisure-time physical activity was categorized into four patterns: 'physically inactive', 'irregularly active', 'regularly active, not intensive', and 'regularly active, intensive'. About 53% of the respondents were physically inactive, 15% irregularly active, 14% regularly active, and only 18% were regularly active, intensive. Women were less active than men anc persons of lower socioeconomic status(SES) were less active than higher SES. Physical activity was not significantly associated with smoking status, drinking pattern and overweight, but negatively associated with daily smoking amount and total duration of smoking in smokers. Individuals with higher lever of physical activity were more likely to check blood pressure regularly and have had screening examination for stomach cancer. Conclusively, the proportion of Korean people who perform appropriate level of physical activity in terms of health promotion is still very low, thus an enforced intervention program becomes indispensable to achieve the national health goal by the year 2000.; Summary

Effect of Non-dietary Factors in the Etiology of Stomach Cancer.: Soo Yong Choi, Hye Sung Park, Hyun Sook Kim, Cha Kwon Chung; Korean J Epidemiol. 1998;20(1):102-112.

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BACKGROUND
Stomach cancer is the most malignant neoplasm among Koreans. There are some studies on risk factors for cancer prevention. SUBJECTS AND METHODS: A case-control study was conducted at the Korea Cancer Center Hospital in Seoul between April and September in 1996. One hundred twenty-six stomach cancer patients confirmed by the histological diagnosis were compared with 234 control subjects mached by age, sex, and admission date. The questionnaire included information on sociodemographic characteristics, smoking and drinking habits, height, weight, family history of cancer, nutrient supplements intake etc. Associations of stomach cancer with con-dietary factors were evaluated. Multiple logistic regression models were used to estimate relative risks when controlling simultaneously for covariates.
RESULTS
Weight and body mass index(BMI, kg/m2) at diagnosis were significantly low in cases compared with controls. As non-dietary factors, smoking habits, alcoholic beverage, family gistory, physical activity, water supply, stress, vitamin suppliments and the use of functional foods were not associated with stomach cancer risk.
CONCLUSION
Our findings indicated that non-dietary factors were not associated with stomach cancer risk.; Summary

Effect of Dietary Factors in the Etiology of Stomach Cancer.: Hye Sung Park, Hyun Sook Kim, Soo Yong Choi, Cha Kwon Chung; Korean J Epidemiol. 1998;20(1):82-101.

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Abstract PDF: Abstract
BACKGROUND
Stomach cancer is the most malignant neoplasm among Koreans. There ane a number of epidemiological studies on dietary factors of stomach cancer in many countries. However, analytical studies on Korean dietary factors are very scarce. SUBJECTS AND METHODS: A case-control study was conducted at the Korea Cancer Center Hospital in Seoul between April and September in 1996. One hundred twenty-six stomach cancer patients confirmed by the histological diagnosis were compared with 234 control subjects matched by age, sex, and admission date. A food frequency questionnaire asking the consumption frequency of 85 selected food items was used to gather the information from all subjects via a face-to-face interview. Multiple logistic regression models were used to estimate relative risks when controlling simultaneously for covariates.
RESULTS
An increased risk of stomach cancer was noted among those with low economic status, fast eating rate, high eating out, hot-temperature soup preference, salt preference, cucumber Kimchi intake, use of pickled fish in Kimchi. Intake of garlic, green onion, tofu, mung bean pancake, acorn-starch paste, starch vermicelli with mixed vegetables, total fruits, citrus fruits, cabbage, green peppers, spinach, mushrooms and total meat appeared to be protective. Stomach cancer risk was not associated with intake of rice, dairy product, fishes, condiments, coffee, tea, and the cooking methods. These data suggested that the high intake of salt and smoked or pickled food may be associated with a hig risk of stomach cancer, and this association could be due to a intragastric formation of nitrosamines. The negative association with fruits and some vegetable consumption may be due to the inhibition of nitrosation process.
CONCLUSION
Our findings indicated that dietary factors contributed to stomach cancer occurrence in Korea, and this may offer clues for further ethnical and prevention research.; Summary

Reproductive Factors Related to Serum Estrogen, Progesterone, and Sex Hormone Binding Globulin in Postmenopausal Women in Korea.: Chul Hwan Kim, Sue Kyung Park, Heon Kim, Mi Na Ha, Hai Rim Shin, Bu Ok Lee, Dae Sung Kim, Dae Hee Kang, Keun Young Yoo; Korean J Epidemiol. 1998;20(1):70-81.

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The etiology of breast cancer is not yet clear. Several epidemiologic studies have supported the concepts that endogenous female sex hormones, i.e., estrogen and progesterone, may play a central role in the development of breast cancer. Female reproductive factors such as menstruation, pregnancy, and breast feeding are well-known risk factors of breast cancer. There have been many suggestions that all these factors are midiated by female sex hormeones. However, only a few studies have evaluated the relationship between the reproductive factors and endogenous female sex hormones. This study was designed to evaluate the relationship between the reproductive factors and endogenous female sex hormones in Korean women. We analyzed the relationship between reproductive factors and female sex hormones in 153 premenopausal women 153 postmenopausal women who participated in a community health promotion program in Haman County, Korea. The questionnaires about reproductive factors were completed by personal interview. Serum level of total estradiol(E2), progesterone(:g), and sex hormone binding globulin(SHBG) were measured by radioimmunoassay. There was no significant correlation between age at menarche and E2 in both premenopausal and postmenopausal groups. In postmenopausal subjects, E2 level increased significantly with the age at menopause increasing(r=0.25, p=0.009), adjusting for the potential confounding effect of both age and body mass index. There was a positive correlation between E2 and the intervals between age at menarche and age at menopause(r=0.25, p=0.009). Moreover, the serum level of SHBG was significantly correlated with total months of breast feeding(r=0.19, p=0.048), as well as with age at first fullterm pregnancy(r=-0.24, p=0.01). However, Pg was correlated with none of reproductive factors in both groups. This study observed that female reproductive factors, e.g., age at menopause, breast feeding, age at first fullterm pregnancy, were correlated with serum female hormones, particularly E2 and SHBG. The results provide an evidence that the relationship between the reproductive factors and breast cancer risk may be mediated, at least in part, through serum female hormones, especially estradiol in Korean women.; Summary

Cigarette Smoking, Alcohol Consumption, and Breast Cancer in Korea.: Dae Hee Kang, Keun Young Yoo, Sue Kyung Park, Hye Won Koo, Jun Suk Suh, Young Chul Kim, Dong Young Noh, Kuk Jin Choe; Korean J Epidemiol. 1998;20(1):60-69.

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A hospital-based case-control study was conducted to assess the relationship between cigarette smoking, alcohol consumption, and the risk of bgreast cancer in Korea. Histologically confirmed incident cases of breast cancer(n=146) were selected from the inpatients at the Department of Surgery, Seoul National University Hospital and Borame Hospital during 1994 to 1997. Women ithout self-reported past history of any malignandies were regarded as controls and selected at the same hospitals during the same period(n-153). Information on life-styles including cigarette smoking, alcohol drinking, and reproductive history were obtained by direct interview using standardixed questionnaire. Each case was matched with one control by 5-year age category(n=146). Adjusted odds ratios and 90% confidence intervals were estimated by unconditional linear logistic regression model. For smokers, age at first smoking was significantly associated with the breat cancer risk(adjusted OR=14.1, 90% CI=1.24-364.2). Particularly noteworthy was an increasing tendency of the breast cancer risk with the duration of alcohol consumtion in years aong alcohol drinkers(ptrend<0.1). These findings suggest that cigarette smoking at an earlier age and alcohol intake might contribute to the risk factor of breast cancer in Korean women. Further investigation on the association between genetic polymorphism of xenobiotic metabolism enxymes of environmental carcinogens and breast cancer should be needed.; Summary

Association of Lifestyle and Hypertension in Rural Population.: Byung Mann Cho; Korean J Epidemiol. 1998;20(1):51-59.

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To evaluate the association of individual health-related lifestyle and hypertension in rual population, data from a population sample of 633(257 men and 376 women) aged 40 years and older and residing in a rural area were analyxed cross-sectionally. The data had been collected by personal interview using structured questionnaire during August 1996. In multivariate analysis, adjusted prevalence rate ration of bypertension increased significantly with increasing amount of coffee drinkin(cups/day) in men(p=0.029) and body mass indes(kh/m2) in women(p=0.013). The level of perceiving his or her own health status was a positive correlate of hypertension in men(p=0.034) and women(p=0.107). Thus, in this population hypertension appears to be associated with coffee drinking in men, body mass index in women and the proportion of awareness of his or her own hypertension seems to be low.; Summary

A Study on the Relationship Between Smoking Habits and BMI of Adult Males.: Joo Hee Han, Myung Kim, Dae Hyu Oh, Hee Choul Ohrr; Korean J Epidemiol. 1998;20(1):39-50.

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Smoking, obesity and diet are just a few of the multifactors which have been suggested to be associated with the risk of CHD. It is a common phenomenon that persons who stop smokin gain weight. This fear of gaining weight is often given as a reason for giving up to quit smoking. The purpose of this study is to find the effects of cessation of smoking on body weight and the difference of BMI distribution according to smoking habits. The subjects of this study were 72 techinical high school teachers in Seoul and Kyounggi-Do, 85 offical wokers of the S-Company and 81 auto industrial workers in PyoungTaek. The investigation for this study has been conducted from Oct. 27th to Oct. 31st 1997. The method was self-feported questionnaire survey which consists of general characterisics, smoking habits and its relevant questions. The questionnaires were revised after two-times of pre-tests, carried out for twenty subjects. The results are as follows ; 1. Smoking habits have significant relations with diet, exercise, drinking and the amount of daily smoking. 2. BMI among different smoking habits groups showed significant differences in following variables ; age, the interaction between exercise and smoking habits, drinking level, the interaction etween drinking level and smoking habits and the interaction between total smoking duration and smoking gabits. 3. The mean values of BMI are 23.5 in non-smoker, 23.8 in ex-smoker and 23.4 in current smoker. There are no statistically significant differencs among amoking habits. 4. The average of 2.14kg weight gain is witnessed after 6 months of the cessation of smoking. Current weight was high by 3.89kh in average compared to the pre-cessation weight(p=0.0001). 5. The odds ratio for gaining weight among ex-smokers is 8.94 in "increase or very increase" group in diet compared to those of "no change". 6. The multiple regression analysis has a significant model in current smoker(p=0.001). The mean BMI of those who were "very active" in exercise is higher than that of "inactive" or "active". The mean BMI of those who were "light or moderate ot heavy drinker" is lower than that of "non-drinker". The mean BMI of those who have the monthly income 1.5millions-1.99millions won is significantly higher than those having less than 1.5millions or more than 2.0millions won. The implication of this study could suggest that health education for smoking cessation needs new approches to minimize weight gain.; Summary

A Case of Ulceroglandular Tularemia Occurred In Korea.: Hyun Sul Lim, Hae Kwan Cheong, Woo Sup Ahn, Moon Youn Kim, Dong Hoon Kim; Korean J Epidemiol. 1998;20(1):32-38.

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Tularemia is a zoonosis caused by Francisella tularensis. It is primarily a disease of wild animals. Human infection is incidental and usually results from interaction with biting or blood-sucking insect, wild or domestic animals or the environment. It is common in United States. An increasing number of cases have been reported from the Scandinavian countries, eastern Europe, Siberia, and Japan. But In Korea it has not been reported. A 40-year old male visited the department of Surgery on Jan 13, 1997 complaining multiple swollen lymph-nodes on his axillae and upper right arm for about ten days. On Dec 25, 1996, he found a dead wild rabbit at mountainside nearby, cooked it himself and ate it with his friends. He informed us that he got light injury on both hands while he was walking on the mountainside. On Dec 28, he started to suffer from high fever, fatigue and loss of appetite lasting for a day. After medication at a local clinic for several day, symptoms were somewhat relieved. A week later(Jan 4, 1997), several erythematous lesions developed on his both hands, which left ulcerations on the skin. Both axillary lymph nodes were swollen at both sides, but not tender. He visited the department of surgery on Jan 13 and he admitted on Jan 15. During hospitalization, the lymph nodes were surgically removed from both axillae and upper left arm. On microbiologic examination, small aerobic gram negative coccobacilli were grown on the chocolate agar plate in aerobic condition with 5% CO2 at 37 degrees centigrade. On Feb 10, fine needle aspiration from the liver abscess was done, drawing 3 ml of yellowish thick pustular material, but the microorganism was not isolated at the smear and culture of this material in the same condition as described above. After admission, he was treated with antibiotics(cefazole and marocin). His general conditions and laboratory results, including liver function, were markedly improved. He was discharged on Feb 12 and appears well on subsequent follow-ups. The microorganism and lymph nodes were sent to Centers for Disease Control and Prevention in the United States for further evaluation. A twostep indirect immunoalkaline phosphatase technique using an anti-F. tularensis antibody was performed on the lyph nodes having a positive reaction. The immunohistochemical stain demonstrated intense positivity in the stellate abscesses and fine granular reaction in some of the vessels in the paracortical region. Also F. tularensis was identified in the agar plug by culture morphology and immunofluorescence antibody test. We report a case of F. tularensis in Korea for the first time. Further studies were recommened for epidemiological characteristics and prevention of the disease.; Summary

Reviews

Methodological Review of Cost Effectiveness Analysis of Cancer Screening.: Ki Taig Jung; Korean J Epidemiol. 1998;20(1):13-31.

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Abstract PDF: Abstract
The role of economic evaluation for medical services can be summarixed as providing objective criteria for rational bgudget allocation. With medical and epidemiologial studies, cost effectiveness analysis of cancer screening will provide evidence for allocating more financial resources for cancer screening. This study reviewed comprehensive literature of cancer screening for cervical cancer and breast cancer. Through the extensive review of the literature, I suggest crucial issues of cancer screening and checkpoints in designing costeffectiveness analyses of cervical and breast cancers. The issues of cervical and breast cancer screening include ages of starting and terminating mass screening, screening interval and frequency, false positive rate, false negative rate, analytical models, and sensitivity analysis. In addition, cost effectiveness analysis of breast cancer should consider effects of screening methods-self examination, clinical examination, and mammography-that varies across different nations on cost effectiveness ratio. Study results of most issues would be relevant for performing cost effectiveness analysis of cancer screening in Korea. However, difference in incidence rate, medical fees and reimbursement by insurance across nations should be considered in designing cost effectiveness analysis.; Summary

General Perspective of Cancer Screening System in Japan and the Epideiologic Evaluation of its Effectiveness and Efficiency.: Ichiro Tsuji; Korean J Epidemiol. 1998;20(1):10-12.

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Abstract PDF: Abstract
No abstract available.; Summary

Current Status of Cancer Screening Rate and Epidemiologic Study for Evaluating the Effectiveness of Cancer Screening in Korea.: Won Chul Lee; Korean J Epidemiol. 1998;20(1):1-9.

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Abstract PDF: Abstract
Current status of cancer screening rate and epidemiologic study for evaluating the effectiveness of cancer screening in Korea are reviewed. There are only few studies for an analysis of the current cancer screening status and associated factors in a community. Among these, a study which were done at Uijongbu city, showed the results on follows ; in the case of the screening of the stomach cancer, 16.1% of male subjects and 25.8% of female subjects turned out to have had one or more screenings for the cancer. In the cases of the breast and cervical cancers, 21.6% and 62.6% of the subjects turned out to have had one or more screenings respectively. The main epidemiologic studies which were for cancer screening effectiveness evaluation were case-control studies for stomach, cervix and breast cancer. According to these studies ; odds ratio was 0.71(95% confidence interval 0.36-1.40) for stomach cancer, 0.53(95% confidence interval 0.33-0.85), cervix cancer and 0.43(95% confidence interval 0.25-0.75) for breast cancer. Establishing cancer screening recommendation to promote national cancer control program and increasing cancer screening rate are needed to reach the goal of reducing cancer mortality and morbidity.; Summary

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